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7 Breastfeeding positions to enjoy the experience

Breastfeeding positions, If you are a new mother, you may find it difficult to breastfeed your newborn until you have some practice. But a little preparation can help you feel more comfortable.

Before you start breastfeeding, take a look at your surroundings. Many mothers like to sit in a rocking chair or a cozy chair with armrests. Steps and cushions may offer more comfort (try special breastfeeding cushions or cushions with armrests for breastfeeding in bed).

When breastfeeding or lifting your baby, it is also important to find a position that is comfortable for both of you. Here are some common positions you may want to consider.

Position

It’s the way the baby is placed to suck.

There are also different ones and all of them can be used, although some can be more effective than others depending on the circumstances. The important thing is that it should never hurt.

Points to consider

The normal thing is to spend many hours a day breastfeeding, if we do not seek to be comfortable, our back is going to hurt and the feeding sessions will be endless. It is a good idea to have a comfortable place to nurse during the day, which could be an armchair, for example. It is also a good idea to have cushions to support your arms while holding the baby or to support the baby if you occasionally need a free hand, and if you are sitting, a footrest.

In the past it was recommended that the mother have a straight and well-supported back, with her shoulders back, but recently it has been found that babies suck better when the mother is leaning back. You can also breastfeed straight.

The important thing is to never breastfeed bent over the baby. In any case it is important to provide good support in the lumbar and cervical area by means of cushions or similar. If possible, you can also breastfeed on the knees.

As the first weeks of breastfeeding are usually long, it is always advisable to have everything you need at hand before you start (tissues, telephone, remote control, book, glass of water, etc…).

Breastfeeding mother and baby. Cenital view

Baby position at the breast

Regardless the mother has several positions to choose from when nursing, there are also different positions to place the baby in and multiple combinations of both.

In any case, and whatever the posture or position chosen, it is important to verify that the baby’s grip on the breast, as well as his sucking, is correct, with his mouth wide open, his lips everted, his tongue under the nipple and with his nose and chin touching the breast.

Could the baby choke?

Babies are born with a strong survival instinct, and they decisively turn away from anything that obstructs their airway. In fact, when a baby has a cold and the mucus held in his nose prevents him from breathing, he will pull his head back from the breast, because he cannot suck and breathe through his mouth at the same time. There is no need to pinch the breast with your fingers or pull the baby’s nose away. The characteristic “flat nose” of babies allows them to breathe through their nostrils even though their face is literally attached to the mother’s breast.

Close up of a baby sucking breast. Black and white photo.

Spontaneous grasp and biological posture

Just like all other baby mammals, our baby is able to reach the breast and suck on its own properly if we allow him to do so.

Everything flows better when we don’t follow techniques and let everything happen spontaneously. To do this, you should be semi-lying down or sitting down with your back leaning back, and place your baby face down on you, with its head placed between your bare breasts, so that not a single piece of your baby’s body is left out of contact with yours. There is no need to hold him, just watch him, because gravity itself holds him steady.

Baby boy lying on his mother's chest breastfeeding
There is no need to hold him, just watch him .

Allow your baby to nod, look for and choose a breast, and tap repeatedly with his chin until he latches on. It may take 10 to 60 minutes if your baby has just been born, less than 10 minutes if he has been breastfeeding for a while. Sometimes the size and shape of the breast can make the process difficult. If this is the case, you can offer her the breast by holding it between your thumb and index finger, as if it were a sandwich.

The ventral posture, which has also been called “biological breeding”, in direct body to body contact, is the one instinctively adopted by all primate suckling babies. It has been proven that human babies can suck effectively and without harming their mother in this position even if they have some mechanical limitation in sucking.

Other mother’s breastfeeding positions:

  • Sitting
  • Stretched
  • Standing
  • On all fours
very close detail of a baby sucking mother's breast

Baby’s position at the breast

Although it is most common to breastfeed sitting or lying down with the baby in front of the mother, there are many positions that can be used:

Sitting position

The baby stretched out in front of the mother in contact with her body, sucking from one breast and with his feet towards the other breast. This is the most common.

Breastfeeding position sitting

A variant of the previous position is to place the baby in the opposite way, also stretched and turned towards the mother, but with the feet on the other side.

This variant is not as common but can be useful if the baby refuses, for whatever reason, to suckle at the breast. If placed on the rejecting breast in the same way as the other breast, the baby may accept it.

“Rugby” position

The baby’s body passes under the mother’s arm and her feet are pointed at her back.

Breastfeeding rugby position

This position is very useful to drain the ducts that are on the external face of the breasts and thus prevent, or if it is the case cure, possible obstructions or mastitis that, although it can occur in any area of the chest, are usually more frequent in that one.

Both the stretched and “rugby” positions work perfectly well if the mother, instead of sitting, is placed in a semi-reclined position.

Rocking horse position

In this position the baby is sitting astride one of the mother’s legs.

Breastfeeding position rocking horse

Although rare, this position can be very helpful with babies who have difficulty latching on, either because of retrognathia (short or retracted lower jaw) or other causes.

In this position, when you introduce the breast into the baby’s mouth, the nipple should point “upwards” towards the palate, so that a good portion of the breast rests on the lower lip, making it easier to latch on.

Stretched (parallel)

Breastfeeding position stretched

In this case, both the position and the posture are frequent as this facilitates the mother’s rest.

This is particularly useful if the mother still feels discomfort after the birth, especially if she has had an episiotomy or a C-section.

Reverse parallel position

Breastfeeding position reverse parallel

In this case the baby’s position is less frequent than the previous one but there are mothers who are comfortable with it and it can also be useful, just like the “four-legged” position, in case of acute obstructions or mastitis located in the upper part of the breast.

“All four” position

Breastfeeding position all four

This position is rare in daily breastfeeding.

But it is a resource to be used in the event that the mother has an obstruction or acute mastitis located in the upper part of the chest, since this facilitates the drainage of those ducts.

All these positions are typical of babies with a still very limited autonomy of movement. Older babies can comfortably suck in the most unlikely positions.

The important thing is to know that there is no single correct position or posture suitable for all the mothers and childs, but that each pair will have to find the postures and positions that best suit their mutual preferences and also the physical characteristics of both.

How to position the baby at the breast, step by step

  1. The mother stands in the chosen posture with her back and feet well supported.
  2. The child is brought close to the chest where it is without being moved.
  3. The baby is placed perpendicular to the orientation of the nipple.
  4. Focus on the nose and the nipple.
  5. Before your baby open his mouth, without tilting, bending, or turning your neck, your nipple should be in front of his nose.
  6. When he opens his mouth, bring the baby quickly and decisively to the breast.
  7. Mother and child must be left body to body (face to face)
  8. The nipple should be pointed at the baby’s palate.
  9. The breast should never go towards the baby, it is the child who goes towards the breast.
  10. The baby’s head should not be at the elbow but on the forearm.
  11. The mother does not hold the baby by the buttocks with that hand, but it is halfway down the back, although she can hold the baby with the other hand.
  12. It is advisable to avoid using clothes or blankets that increase the baby’s distance from the breast.
position the baby at the breast. Mother nursing her baby next to the window.

Signs of good position

  • The baby’s head and body are in a straight line.
  • The baby’s face is facing the breast.
  • The mother keeps the baby close to her.
  • If the baby is a newborn, the mother wraps it in a hug. She doesn’t just hold him by the neck and shoulders.

Signs of a good grip

  • The baby’s chin and nose are near to the mother’s breast.
  • The baby’s lips are everted, especially the bottom one which is bent downwards.
  • The baby’s mouth is wide open.
  • More areola is seen above the baby’s mouth than below

Signs of good suction

At first the suction is fast and shallow. After about a minute it changes to slow, deep suction, with pauses in between. The normal pace of a newborn’s sucking is in cycles of 10 to 30 sucks where the baby breathes normally without the need to break the suction. If your baby sucks 3 to 5 times in a row, followed by a pause of the same length in the sucking episode in order to breathe, he or she is likely to have immature sucking and this may cause difficulty feeding.

Typically, if there is ambient silence, you can hear swallowing for a few minutes at each feeding while watching for a wide jaw movement that indicates swallowing.

You will also be able to see that:

  • The baby’s tongue is under the areola.
  • A movement is observed at the point of articulation of the jaw.
  • The cheeks do not sink, but look round and full.

Please note:

The position of the child at the breast is one of the most influential aspects of successful breastfeeding.

Nursing is an active process on the part of both its protagonists, mother and child. On the one hand, the milk does not wait patiently at the breast for someone to pump it, but is pushed by the action of a hormone, oxytocin. The baby is not passive either, he does not wait with his mouth open for the milk to fall out on its own, but he has to make some determined sucking movements to obtain all the milk he needs. For this whole process to be optimal, the baby’s position and sucking must be correct and the tongue must be fully mobile as problems can arise if the sublingual frenulum is short.

Alternating different positions facilitates the correct drainage of all the breast ducts and prevents the appearance of obstructions and mastitis.

Breastfeeding is not a totally instinctive process in human beings but it requires social learning. Seeing other mothers breastfeed their children correctly makes it easier for the mother herself to hold the baby to suck in the right position.

It has been observed that, when at the very moment of birth (before washing, weighing, ophthalmic prophylaxis or any other maneuver; sometimes even before cutting the cord) a newborn is placed naked on the naked body of his mother, and left with her for two hours without interruption, almost all babies crawl to the breast, locate the nipple and suck spontaneously in the correct position, at a time varying between about 20 minutes and just over an hour after delivery.

However, it has also been observed that many newborns are unable to breastfeed correctly if they are under the effect of the spinal anaesthesia given to the mother during delivery, or if they are separated from the mother for more than 20 minutes (between 20 and 40 minutes postpartum), even if they are then left in contact with the mother again. When both factors coincide (peridural and brief separation) almost no newborn is able to suckle in the correct position.

Newborn being nursed while sleep

Important factors

These elements favour the correct position of the baby at the breast:

  • Good information from the mother.
  • The early start of breastfeeding.
  • Avoiding the use of pacifiers and bottles to prevent Nipple Confusion Syndrome.
  • Professional support during the hospital stay

The signs and symptoms of Improper Positioning Syndrome could be:

  • Sunken cheeks, rapid and noisy sucking, perioral movements.
  • Nipple pain and cracks.
  • Not letting go of the breast on your own.
  • Ingurgitation, sometimes mastitis.
  • Intense and repeated ejection reflex.
  • Choking, sometimes rejection of the breast.
  • Vomiting and regurgitation.
  • Poor weight gain.
  • Frequent and prolonged feedings (feedings of more than one hour that almost overlap each other, may be normal in some children of a few weeks, but may also indicate bad position, so when in doubt it is convenient to verify the position and suction of the baby).

Signs of “Nipple Confusion Syndrome” due to interference from pacifiers and bottles may be:

  • The baby “fights” with the breast in some feedings, seems nervous, confused and ends up holding on correctly after a while that seems to be unsuccessful. It is possible that at first he will do it alone in some feedings, but if the nipple interference continues, he will end up doing it in all feedings and even in some times he won’t be able to latch on until he stops sucking completely.
  • When the baby’s mouth is very closed, he is only able to reach the nipple and not the areola.
  • And the position and movements of the tongue differ, the baby tends to move the tongue in front of the nipple instead of under it.
Baby and mother at the beach. The mother holds the baby to be face to face.

 

Some physical factors, both on the baby’s side (short lingual frenulum, retrognathia, …) and on the mother’s side (size and orientation of the breast or nipple, …) can make it difficult for the baby to latch on to the breast. In some cases it will be necessary to intervene externally (cut the short brace), in others it is possible that the problem only occurs in certain positions. If this is the case, it will be a question of identifying which position is the most suitable for the mother/child pair.

Flat or inverted nipples do not have to be an obstacle for a correct position, since the baby sucks from the areola, not from the nipple.

The use of nipples could be convenient in some difficult cases in which the baby is unable to latch on in any other way, but it can also be the cause of other problems, such as low milk production, so their use must be very prudent.

Woman on the beach walking on a wooden dock holding a baby

Clamping the breast between the index and middle fingers can be a risk factor for poor positioning and sucking, as it prevents the baby from grasping the breast well with his mouth. It can also increase the risk of blockages. If a one-handed hold is needed, it is best to use the thumb and index finger in a “C-shaped” position above and below the areola without compressing the breast.

Redirecting inadequate positioning or sucking to successful and satisfactory breastfeeding is possible, with proper information, patience and support.

Bibliography:

  1. Breastfeeding. Lawrence, R.A. Mosby / Doyma Books, S.A. Madrid 1996
  2. Breastfeeding. Manual for professionals. Royal College of Midwives. ACPAM. Barcelona 1994
  3. Breastfeeding. Aguayo, J. University of Seville. Seville, 2001
  4. Practical manual for breastfeeding. ACPAM. Barcelona, 2004

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